Abstract:
BACKGROUND:AF can be induced by RAP or ISO in >85% of patients with PAF. METHODS:ISO was administered in escalating doses of 5, 10, 15, and 20 microg/min in 112 patients (age = 56 +/- 13 years) with PAF before radiofrequency catheter ablation. AF was inducible in 97 of 112 patients (87%) at a mean dose of 15 +/- 5 microg/min. RAP induced AF in the remaining 14 of 15 patients. Antral pulmonary vein (PV) isolation (APVI) was followed by ablation of complex fractionated atrial electrograms (CFAEs) as necessary to terminate AF and render AF noninducible in response to ISO. RESULTS:AF terminated during APVI in 72 of 111 patients (65%) and after APVI plus ablation of CFAEs in 11 of 111 patients (10%). In the remaining 28 patients (25%), sinus rhythm was restored by transthoracic cardioversion. RAP was performed in the last 61 consecutive patients who were rendered noninducible by ISO. RAP initiated AF in 20 of 61 patients (33%) and atrial flutter in 6 patients (10%). No additional ablation was performed if AF was induced with RAP; however, atrial flutter was targeted. At 12 +/- 5 months, 63/75 patients (84%) who were noninducible by ISO and 2 of 8 (25%) who still were reinducible by ISO were free from recurrent AF after a single ablation procedure without antiarrhythmic drugs (P = 0.001). AF recurred in 20 of 36 patients (56%) who required cardioversion for persistent AF after ablation (P < 0.001). Among the 61 patients who also underwent RAP, 12 of 20 (60%) who were, and 31 of 41 (76%) who were not inducible by RAP were free from recurrent AF (P = 0.21). The accuracy of noninducibility as a predictor of clinical outcome was 83% with ISO and 64% by RAP (P = 0.03). CONCLUSIONS:The response to isoproterenol after catheter ablation of PAF more accurately predicts clinical outcome than the response to RAP.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Crawford T,Chugh A,Good E,Yoshida K,Jongnarangsin K,Ebinger M,Pelosi F Jr,Bogun F,Morady F,Oral Hdoi
10.1111/j.1540-8167.2009.01571.xsubject
Has Abstractpub_date
2010-01-01 00:00:00pages
13-20issue
1eissn
1045-3873issn
1540-8167pii
JCE1571journal_volume
21pub_type
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journal_title:Journal of cardiovascular electrophysiology
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journal_title:Journal of cardiovascular electrophysiology
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doi:10.1111/j.1540-8167.1996.tb00472.x
更新日期:1996-10-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
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更新日期:2020-08-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02246.x
更新日期:2012-06-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13325
更新日期:2017-12-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01704.x
更新日期:2010-07-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02243.x
更新日期:2012-05-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.03344.x
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Thrombi form mainly in the left rather than the right atria of patients with atrial fibrillation (AF), the reason of this predilection being unknown. OBJECTIVE:The purpose of this study was to investigate whether atrial-specific differences in endothelial damage, leukocyte activation, platelet stimulation, ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
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更新日期:2014-03-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
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journal_title:Journal of cardiovascular electrophysiology
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doi:10.1111/j.1540-8167.1995.tb00378.x
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2007.00925.x
更新日期:2007-11-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
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更新日期:2010-12-01 00:00:00
abstract:INTRODUCTION:The difficult catheter orientation and navigation associated with conventional technology and mono-/multiplane fluoroscopy may complicate ablation procedures of atrial tachycardias. A new three-dimensional catheter technology for electroanatomical mapping of the right atrium and ablation of ectopic atrial ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1997.tb01029.x
更新日期:1997-12-01 00:00:00
abstract:INTRODUCTION:Reduction of radiation exposure during cardiac arrhythmia ablation procedures is desirable. We sought to evaluate the utility of a new image integration module (CARTOUNIVU(TM) ) in reducing fluoroscopy times and dosages during left atrial arrhythmia (LAA) and ventricular tachycardia (VT) ablation procedure...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
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更新日期:2015-06-01 00:00:00
abstract::Catheter ablation for ventricular tachycardia (VT) is becoming an essential component of the successful management of patients with structural heart disease and refractory ventricular arrhythmias. Despite detailed mapping and ablation from the endocardium, nearly a third of VT circuits remain inaccessible. Pericardial...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
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更新日期:2009-06-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2002.00525.x
更新日期:2002-06-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
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更新日期:2015-04-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.03429.x
更新日期:2004-03-01 00:00:00
abstract::Similar to the surgical mini-maze procedure, the posterior "box" lesion set employs linear ablation lesions along the anterior aspects of both sets of PVs connected by a roof line and an inferior line to electrically isolate the PVs and complete posterior LA wall en masse. However, creating fully transmural linear atr...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2007.00944.x
更新日期:2008-03-01 00:00:00